Cerebral Anaemia is means due to insufficient amount of blood circulating in the capillaries.
SYMPTOMS
Amongst the symptoms can be counted mental and physical. First of all, it is not necessary to get bogged down by academic qualifications attributed to the symptoms (also called 'legions') which, generally appear concurrently, but rarely severally. In most of the cases, symptoms are found jumbled, but can be discerned by physical and mental conditions of the patient. Undermentioned symptoms may be observed in a neurasthenic patient
* Inability to perform even normal (routine) chores which were quite easy to perform earlier.
* Inability to concentrate mind on one subject, not even me ones that directly affect him.
* Disinclination to perform any physical labor or mental work - a sort of disinterest and apathy to either or both.
* Frequent and sudden changes in mood which are irritable and excitable.
* Emotional, temperamental and behavioral agitation and irritability.
* Always angry, peevish or else brooding and submissive, but is generally unrelenting and quarrelsome and uncompromising and doesn't relish, entertain or
listen to even same advice, and takes everything as an amiss.
* Sleep is the main casualty - it is disturbed or lacking, unrefreshing and fatiguing. The patient remains awake during first part of night or else sleeps in that part and remains awake for rest of the period. During the daytime, he is abnormally drowsy, sloth and inactive. When he gets up, his head aches and is heavy. There may also be sour/bitter acidic eructation’s, gas, pain in. Stomach, rumblings, constipation and general lassitude and restively.
* There is pressing pain on the vertex, along with burning in the occipital & down the spine,
* Hearing disorders, like humming and buzzing ears, precipitated by different noises, roaring and distant noises. Vertigo may also surface due to hearing problems.
* Sight is also affected abnormally when there is unnatural mobility of pupils which readily react to light, but are sluggish to certain accommodative defects.
* In certain patients nausea and/or vomiting of ingest is also present which is a direct outcome of defective digestion,.
* There are pains and aches in bones and muscles, a feeling of tiredness and of not being well or normal. Numbness, along with fornication, in a single or all parts
* Feeling of a run-down condition, of being out of sorts.
* Among the vasomotor symptoms, sweating and blushing are more prominent.
* Sexual dysfunction, reclusion/withdrawal, or the desire may be fully lost or else excessive. Erections may be rare but premature ejaculation often results. Sex organs are flabby, cold and relaxed, so to say. If there is extreme sexual disturbance, it may also result in fear, suicidal tendency, and fear of all sorts. The patient feels unsecure, neglected and despised.
* There may be hot flushes or cold chills - indicating thermic disturbances.
PROGNOSIS
Pure and uncomplicated can be managed and cured without much difficulty but those having some 'habits', are not so easy to cure. Moreover, neurasthemic states cannot be easily discerned from hysteria, insanity, sexual perversions and deviations, effects of addictions and diehard and in-build habits. But, it can be easily differentiated from other diseases of Nervous system, ataxia, brain tumors, digestive disorders, liver disorders. As for cardiac disorders, the totality of symptoms doesn't afford much chance to single out the contributory cause(s). The physician can help the patient to a limited extent only, provided the patient is Honest and forthright in his disclosures. An adamant and reluctant patient is difficult to cure, due to his negative approach to almost every aspect of life. A patient, with reserved disposition, is still more a dilemma for the doctor. In all introvert cases, hypnotherapy can solve most of the complex cases, when physician has full control over the patient. But the million dollar question still remains - will the patient visit a hypnotic centre a physician, of his own or follow and submit to sincere counsel?
KALI PROS
Neurasthenia is a top ranking symptom of this drug. Symptoms include diminished sexual power, Nocturnal emissions, utter prostration after coition, entire nervous system is under agitation, stress and strain; anxiety, nervous dread, lethargy, extreme lassitude and depression, indisposition to meet people, hysteria, brain-fag, highly irritated, Loss of memory night terrors, somnabulance (sleep walk), loss of memory, even slightest labour seems a heavy task, startles easily, disunclined to talk or enter into any conversation, great despondency about work/business; shyness.
COCA (ERYTHROXYLON)
Mental depression and palpitation and anxiety of the heart, general nervous debility, sleeplessness, inclined to move about or work, Nervous weakness causes fainting spells, abdomen distended, sleeplessness, constipation, Nervous debility causes oppressed breathing, cold limbs.
CHINBVUM SULPH
Loss of vital fluids, weakness and trembling of lower limbs, extremities cold, Nervous trembling, Mental/Physical exertion adds to woes of the patient, severe and exhausting illness causes Neurasthenia.
PICRIC ACID
It is excellent restorative of worn-out and wasted nervous system, even least physical or mental exertion suffices to exhaust and cause headache to the patient, useful in brain fag of students, persons; nervosity and agitation due to sexual excesses.
STAPHYSAGRIA
Noctural emissions followed by utter prostration, loss of vital fluids, onanism, excessive sexual indulgence causes nervous exhaustion, loss of memory, backache and headache, nocturnal emissions are followed by utter prostration, inability to perform any physical/mental labour.
AVENA SATIVA
Useful to women who are worn-out, exhausted, worried due to cares and worries of household and also business/professional persons; lack of power of nerve force causes coldness of various body organs; cerebrasthenia. Other remedies recommended are : Zincum Brom, Argent Met, Ignatia, Zincum Phos, Physostigma, Nux Vomica, Arsenic, Calcarea Phos, Strychnia Phos which can be tried according to symptoms.
AUXILIARY MEASURES
- Complete mental and physical rest.
- Massage of whole body, but more so on head, neck, shoulders, hands and feet.
- Balanced and Nutritious diet, Walnut, watermelon and musk melon seeds, coconut water, milk, fruit, and vegetable juices etc.
- Change of environs-preferably shifting to some calm, serene, greenish area.
- Stroll on grass and dew drops.
- Avoid tea, coffee, cocoa, alcohol, tobacco, drugs,
- Remaining engaged in some interesting, absorbing and off-beat entertainment/activity.
- Lukewarm/water bath, at least an hour before retiring to bed and also dip feet in lukewarm water at bed time.
- Light and sustainable physical activity - like outside (out door) sports, yoga and meditation, especially shavaasana (corpose pose), deep contemplation, self-introspection.
- Not entering into useless and offending dialogues and conversation.
Showing posts with label Anemia. Show all posts
Showing posts with label Anemia. Show all posts
Cerebral Anameia: Key Causes & Symptoms
This is also called cerebral hyperemia/brain - fag. In this condition, the blood contained in the cerebral vessels is either of defective quality or is deficient in quality.
SYMPTOMS
Patient is weak, pale and anemic, has disposition to sleep, pulse is weak and small; headache is of neuralgic type and is confined primarily to vertex and forehead. His pupils are dilated, has anemic murmurs. He feels relieved in horizontal position and by administration of alcohol.
Aforesaid symptoms are at complete variance with those existing in cerebral hyperemia; hence there is no occasion for confusion.
All the symptoms stem from insufficient supply of blood to the brain which can be seen by suppressing the breathing by diminishing the supply by compression of the carotid arteries. If the disease is caused by poor or impoverished condition of the blood, the nutrition of the brain suffers due to paucity or deficiency of R.B.C.S that are the carriers of oxygen. In such cases, the effects are similar to that which result from deficiency in quality of blood, but the only visible symptom being that symptoms surface gradually, instead of developing suddenly.
Let us say that anemia lies at the base of this disorder for which China, Picric Acid, Ferrum Phos will serve the purpose. When feeble action of heart is the cause, digitalis will prove useful. In the vasomotor form of cerebral anaemia, Amyl Nitrate, Amyl Brom (3X), Glonoin and Picric Acid can benefit. Phosphorus and Nux Vomica are more useful in Chronic stage of the disease. If there is Vertigo, Baryta Carb, Lyco, Graphites, silica, Fluoric Acid will prove beneficial.
Dr. Hale recommends Atropine as an efficacious remedy in case of advance typhoid, especially when there is insomnia and general prostration, tongue very dry, coma vigil, incoherent mumbling. But Dr. C.P. Hart finds Picric Acid a still better remedy as compared to Atropline
THERAPEUTIC INDICATIONS
Ignatia : Hysterical, weak persons; especially women who have been rendered anemic through grief and/or mental anxiety, are nervous, taciturn, seek solitude and remain sad (melancholy); frequently give way to tears; suffer from excessive milk; weak constitution; have sniking sensation at the pit of the stomach. Effects of sudden shocking news, death of some loved one.
China : For anemic conditions, this remedy tops the list and is of unquestioned value when the. disease is caused by bleeding from any opening (orifice) of the body; when there is excessive loss of animal fluids, leucorrhea, diarrhoea, Spermatorrhoea, and over lactation. It will show its best results when drain on the body has been arrested. It responds also to headache (especially in the morning), pale appearance of face, cold face, and extremities, debility of great magnitude, palpitation; trembling and tingling or twitching of limbs and muscles, faintness, (relieved by lying down), vertigo (especially on raising the head), insomnia, and poor quality of blood.
Arsenic Album: This suits best who are not filthy (as opposed to sulphur), but are choosy and sophisticated, do not like disorder, are neat and clean. Useful when Ferrum Phos is used excessively and imprudently, blood has become watery/ depraved (weak)- may be due to malaria, chlorosis (green sickness) and quinine. Emaciation and great sneaking of (Vital) forces, cold extremities and prostration, restlessness, thirst for small quantities of water, bloating efface, hands and feet, vertigo with vanishing of the senses, mental depression, chilliness.
Ferrum Phos : Bellow-like sound of the heart, headache of beating nature, low R.B.C.S, even slight exertion results in exhaustion and breathlessness. Muscles weak and flabby; passive bleedings and chlorosis. Dr Boericke orders 3x potency to increase R.B.C.S in the blood.
Nux Vomica : Suits best the gents who use too much of tobacco, alcohol, fatty and spicy diets, keep awake at night, are debauches, are anemic due to over-work and exertion, overstimulation by artificial means. Gastric irritation, constipation and indigestion, or else loose motions, nausea and vomiting with frequent eructation’s of sour-smelling food/fluids, muscular twitching, frequent cramps, trembling of hands; suited to professional people and students.
Zincum Met : More suited to old/chronic cases, especially if abuse of Pot.(Kali) Bromide be the cause. Great physical and mental depression, cold extremities, Paralytic weakness along with twitching of the muscles; after writing, reading, study and overwork, the forehead aches; loss of memory; restively at night with frightening and horrible dreams.
Sulphur: It is both a prophylactive and curative, especially when symptoms are masked and oblique, and also when even well selected remedies fail to produce expected results. Useful in chronic, phlegmatic, scrofulous, dirty; filthy and sloth people who do not wish or attempt to do any physical activity eruptions or, dry when the eruptions get suppressed. It can be used as an intercurrent remedy and also to arouse phagocytes (That is R.B.C.S or defence mechanism of the body).
Camphor: Coldness of body, greatly embarrassed circulation and respiration; spasms and convulsions; synovial form when rapid loss of vital fluids is the cause or, loss of consciousness, vertigo. It is a short-acting transition remedy but is very useful in combating crisis situation, in treating urinary symptoms, especially if caused by cholera, dirrhoea etc.
Veratrum Album: Useful in acute cases worsened by violent purging, attended with spasms, convulsions and fainting— accompanied or followed by paralytic weakness. An excellent remedy for run-down conditions.
Auxiliary Treatment: Serve milk, eggs, fish, oysters and vegetables like beats, spinach and carrots and other leafy vegetables; and fruits like mangoes, pomegranates, Grapes etc. Fresh air and moderate exercise, massage with essential oils, salt baths, sea-bathing - but take proper precautions regarding patient's health condition, status and stage of disease.
2. CEREBRAL PARALYSIS
It is also called common Palsy/Paralysis of cerebral origin. The disorder is characterized by loss of the power of voluntarily exciting of muscles of one side of the body, caused by some brain disorder. Here one side is affected more than the other. Paralysis is limited to only those parts that are supplied by specific plexuses and nerves, but cerebral symptoms are generally Choose any of the medicines that meets bulk of symptoms.
These medicines will improve the situation, if not fully cure the malady.
Chamomilla : Hesitancy of speech, stammering, very absent-minded and forgetful : While speaking or writing skips/ omits words; mental vacuum, and dull comprehension.
Arnica : Paralysis of Vocal cords, feeling as if brain is aching and bruised, aphasia related symptoms surface after cerebral bleeding. Patient has stertorous, breathing.
Stramonium : Mind greatly fatigued, intellect confused, talks at random, there is congestion of brain, pupils contracted, near blindness, paralysis of organs speech, stuttering, insensibility . of all senses, loss of memory; unconsciousness.
Baryta Carb : Unable to recollect names of things and individuals, memory fails when words and names are attempted to be recollected, dullness of all senses and mind.
Conium : Confusion of mind with loss of words, uses wrong words while articulating, cannot understand what he is reading; speech difficult, hesitant, loss of entire power of speech, somnolence resulting in stupefaction, loss of memory.
L-"Hesis : Great weakness of (recollective) memory; confuses dates/numbers, makes mistakes while writing, dull comprehension; loses sense of words, unable to understand what he reads />r hears; absence of thoughts.
Causticum : Unable to think succinctly on any subject; congestion of brain and absent-mindedness, great weakness of memory; head feels dull and heavy, extremely erratic and forgetful of names and words.
Other remedies are Phosphorus, Glonoine, Kali lod, Colchicum, Oleander, Anacardium, Pulsatilla, Merc. Sol, Nux Vomica, Hepar Sulph are more indicated in apoplectic symptoms/ conditions.
When the patient is absent-minded and forgetful, try Phos.Acid, Alumina, Platina, Cocculus, Bovista and Hyocyamus. shock or loss, some family, social or job-related problem, lack of adjustment and self-management, are some of the causes which may, in majority of the persons, lead to neurasthenia which is simply an off-shoot of the said and many other factors.
Neurasthenia is a form of Nervous debility, Nervous-exhaustion, cerehro-spinal anaemia or even Brain-fag which are simply other nomeclations of the subject disorder.
It is a functional disorder that affects not only entire nervous system, but also the body as a whole. The symptoms are constantly changing - one giving way to the other, appear and disappear quite suddenly, thus giving a masked and oblique picture of symptoms which, at times, cause a lot of confusion; hence almost difficult to discern. There is hardly any person who can ciaim with confidence that he never had suffered from this malady.
CAUSES
• Heredity - it is the most frequent and exciting cause.
• Exhaustion of vital forces.
• Hypersensitivity and inability to withstand ups and downs of life and resultant events/consequences.
Habitual and regular Drug use, Alcoholism, tobacco use in any form.
Some chronic ailments of one’s own self, some family member or a friend.
Poor diet - bereft of essential nutrients. Excessive use of spices, condiments, meats, poultry products.
Digestion and liver-related problems for which dietary indiscretion and use of stimulants and narcotics is a main factor.
Family problems and inadequate income-not sufficient enough to meet even to let the both ends meet.
Job dissatisfaction, nagging by seniors and defiant and non-co-operative attitude of the subordinates.
Incompatible marriage, where the wife comes from a far richer family, is more beautiful, earns more than her husband, nagging wife. This is also equally true in the case of ladies also who, too, have to face the similar odd time and situations.
Sexual illiteracy and sexual incompetence or incompatibility. Most of the marriages prove dismal failures when either of the partners is sex recluse, frigid or 'Cold', or when sex urge of one partner is so voluptuous and uncontrollable that the other partner is not able to match the velocity of his/her mate. It may be noted that, 'if your sex-life is happy and satisfactory, all else would be in order and, if it is the other way round, nothing else can be in order.' Sexual perversities which the other partner abhors/ dislikes are sufficient means to result in sex withdrawal or hatred.
Extramarital relations, bad habits, late night revelleries, drinking, smoking, foul odour, drive the other partner away and the offended (or say aggrieved) person is obliged to seek sex satisfaction with someone else, at some other place.
Uncompromising, sticky, obsessive and unrelenting attitude, when decisions are forced upon others and no importance is accorded to other person's sentiments.
Here, the other person suffers.
Over-exertion and heavy work-load, when no credit is given for a good work performed.
Lack of sleep and proper restless of job, some dear and near one, property income or gain.
Terrible worry, hurry and scurry of life, when reasonable comfort and mental and physical relaxations are sacrificed for the sake of earning easy & quick money or fame, or even approbation.
Some temporary/permanent physical infirmity
Lack/absence of a sincere, sympathetic and receptive confident
Too much brooding over certain events in life which defy any instant or distant solution
Fear of any kind.
Apprehension about imaginary happenings/losses
SYMPTOMS
Patient is weak, pale and anemic, has disposition to sleep, pulse is weak and small; headache is of neuralgic type and is confined primarily to vertex and forehead. His pupils are dilated, has anemic murmurs. He feels relieved in horizontal position and by administration of alcohol.
Aforesaid symptoms are at complete variance with those existing in cerebral hyperemia; hence there is no occasion for confusion.
All the symptoms stem from insufficient supply of blood to the brain which can be seen by suppressing the breathing by diminishing the supply by compression of the carotid arteries. If the disease is caused by poor or impoverished condition of the blood, the nutrition of the brain suffers due to paucity or deficiency of R.B.C.S that are the carriers of oxygen. In such cases, the effects are similar to that which result from deficiency in quality of blood, but the only visible symptom being that symptoms surface gradually, instead of developing suddenly.
Let us say that anemia lies at the base of this disorder for which China, Picric Acid, Ferrum Phos will serve the purpose. When feeble action of heart is the cause, digitalis will prove useful. In the vasomotor form of cerebral anaemia, Amyl Nitrate, Amyl Brom (3X), Glonoin and Picric Acid can benefit. Phosphorus and Nux Vomica are more useful in Chronic stage of the disease. If there is Vertigo, Baryta Carb, Lyco, Graphites, silica, Fluoric Acid will prove beneficial.
Dr. Hale recommends Atropine as an efficacious remedy in case of advance typhoid, especially when there is insomnia and general prostration, tongue very dry, coma vigil, incoherent mumbling. But Dr. C.P. Hart finds Picric Acid a still better remedy as compared to Atropline
THERAPEUTIC INDICATIONS
Ignatia : Hysterical, weak persons; especially women who have been rendered anemic through grief and/or mental anxiety, are nervous, taciturn, seek solitude and remain sad (melancholy); frequently give way to tears; suffer from excessive milk; weak constitution; have sniking sensation at the pit of the stomach. Effects of sudden shocking news, death of some loved one.
China : For anemic conditions, this remedy tops the list and is of unquestioned value when the. disease is caused by bleeding from any opening (orifice) of the body; when there is excessive loss of animal fluids, leucorrhea, diarrhoea, Spermatorrhoea, and over lactation. It will show its best results when drain on the body has been arrested. It responds also to headache (especially in the morning), pale appearance of face, cold face, and extremities, debility of great magnitude, palpitation; trembling and tingling or twitching of limbs and muscles, faintness, (relieved by lying down), vertigo (especially on raising the head), insomnia, and poor quality of blood.
Arsenic Album: This suits best who are not filthy (as opposed to sulphur), but are choosy and sophisticated, do not like disorder, are neat and clean. Useful when Ferrum Phos is used excessively and imprudently, blood has become watery/ depraved (weak)- may be due to malaria, chlorosis (green sickness) and quinine. Emaciation and great sneaking of (Vital) forces, cold extremities and prostration, restlessness, thirst for small quantities of water, bloating efface, hands and feet, vertigo with vanishing of the senses, mental depression, chilliness.
Ferrum Phos : Bellow-like sound of the heart, headache of beating nature, low R.B.C.S, even slight exertion results in exhaustion and breathlessness. Muscles weak and flabby; passive bleedings and chlorosis. Dr Boericke orders 3x potency to increase R.B.C.S in the blood.
Nux Vomica : Suits best the gents who use too much of tobacco, alcohol, fatty and spicy diets, keep awake at night, are debauches, are anemic due to over-work and exertion, overstimulation by artificial means. Gastric irritation, constipation and indigestion, or else loose motions, nausea and vomiting with frequent eructation’s of sour-smelling food/fluids, muscular twitching, frequent cramps, trembling of hands; suited to professional people and students.
Zincum Met : More suited to old/chronic cases, especially if abuse of Pot.(Kali) Bromide be the cause. Great physical and mental depression, cold extremities, Paralytic weakness along with twitching of the muscles; after writing, reading, study and overwork, the forehead aches; loss of memory; restively at night with frightening and horrible dreams.
Sulphur: It is both a prophylactive and curative, especially when symptoms are masked and oblique, and also when even well selected remedies fail to produce expected results. Useful in chronic, phlegmatic, scrofulous, dirty; filthy and sloth people who do not wish or attempt to do any physical activity eruptions or, dry when the eruptions get suppressed. It can be used as an intercurrent remedy and also to arouse phagocytes (That is R.B.C.S or defence mechanism of the body).
Camphor: Coldness of body, greatly embarrassed circulation and respiration; spasms and convulsions; synovial form when rapid loss of vital fluids is the cause or, loss of consciousness, vertigo. It is a short-acting transition remedy but is very useful in combating crisis situation, in treating urinary symptoms, especially if caused by cholera, dirrhoea etc.
Veratrum Album: Useful in acute cases worsened by violent purging, attended with spasms, convulsions and fainting— accompanied or followed by paralytic weakness. An excellent remedy for run-down conditions.
Auxiliary Treatment: Serve milk, eggs, fish, oysters and vegetables like beats, spinach and carrots and other leafy vegetables; and fruits like mangoes, pomegranates, Grapes etc. Fresh air and moderate exercise, massage with essential oils, salt baths, sea-bathing - but take proper precautions regarding patient's health condition, status and stage of disease.
2. CEREBRAL PARALYSIS
It is also called common Palsy/Paralysis of cerebral origin. The disorder is characterized by loss of the power of voluntarily exciting of muscles of one side of the body, caused by some brain disorder. Here one side is affected more than the other. Paralysis is limited to only those parts that are supplied by specific plexuses and nerves, but cerebral symptoms are generally Choose any of the medicines that meets bulk of symptoms.
These medicines will improve the situation, if not fully cure the malady.
Chamomilla : Hesitancy of speech, stammering, very absent-minded and forgetful : While speaking or writing skips/ omits words; mental vacuum, and dull comprehension.
Arnica : Paralysis of Vocal cords, feeling as if brain is aching and bruised, aphasia related symptoms surface after cerebral bleeding. Patient has stertorous, breathing.
Stramonium : Mind greatly fatigued, intellect confused, talks at random, there is congestion of brain, pupils contracted, near blindness, paralysis of organs speech, stuttering, insensibility . of all senses, loss of memory; unconsciousness.
Baryta Carb : Unable to recollect names of things and individuals, memory fails when words and names are attempted to be recollected, dullness of all senses and mind.
Conium : Confusion of mind with loss of words, uses wrong words while articulating, cannot understand what he is reading; speech difficult, hesitant, loss of entire power of speech, somnolence resulting in stupefaction, loss of memory.
L-"Hesis : Great weakness of (recollective) memory; confuses dates/numbers, makes mistakes while writing, dull comprehension; loses sense of words, unable to understand what he reads />r hears; absence of thoughts.
Causticum : Unable to think succinctly on any subject; congestion of brain and absent-mindedness, great weakness of memory; head feels dull and heavy, extremely erratic and forgetful of names and words.
Other remedies are Phosphorus, Glonoine, Kali lod, Colchicum, Oleander, Anacardium, Pulsatilla, Merc. Sol, Nux Vomica, Hepar Sulph are more indicated in apoplectic symptoms/ conditions.
When the patient is absent-minded and forgetful, try Phos.Acid, Alumina, Platina, Cocculus, Bovista and Hyocyamus. shock or loss, some family, social or job-related problem, lack of adjustment and self-management, are some of the causes which may, in majority of the persons, lead to neurasthenia which is simply an off-shoot of the said and many other factors.
Neurasthenia is a form of Nervous debility, Nervous-exhaustion, cerehro-spinal anaemia or even Brain-fag which are simply other nomeclations of the subject disorder.
It is a functional disorder that affects not only entire nervous system, but also the body as a whole. The symptoms are constantly changing - one giving way to the other, appear and disappear quite suddenly, thus giving a masked and oblique picture of symptoms which, at times, cause a lot of confusion; hence almost difficult to discern. There is hardly any person who can ciaim with confidence that he never had suffered from this malady.
CAUSES
• Heredity - it is the most frequent and exciting cause.
• Exhaustion of vital forces.
• Hypersensitivity and inability to withstand ups and downs of life and resultant events/consequences.
Habitual and regular Drug use, Alcoholism, tobacco use in any form.
Some chronic ailments of one’s own self, some family member or a friend.
Poor diet - bereft of essential nutrients. Excessive use of spices, condiments, meats, poultry products.
Digestion and liver-related problems for which dietary indiscretion and use of stimulants and narcotics is a main factor.
Family problems and inadequate income-not sufficient enough to meet even to let the both ends meet.
Job dissatisfaction, nagging by seniors and defiant and non-co-operative attitude of the subordinates.
Incompatible marriage, where the wife comes from a far richer family, is more beautiful, earns more than her husband, nagging wife. This is also equally true in the case of ladies also who, too, have to face the similar odd time and situations.
Sexual illiteracy and sexual incompetence or incompatibility. Most of the marriages prove dismal failures when either of the partners is sex recluse, frigid or 'Cold', or when sex urge of one partner is so voluptuous and uncontrollable that the other partner is not able to match the velocity of his/her mate. It may be noted that, 'if your sex-life is happy and satisfactory, all else would be in order and, if it is the other way round, nothing else can be in order.' Sexual perversities which the other partner abhors/ dislikes are sufficient means to result in sex withdrawal or hatred.
Extramarital relations, bad habits, late night revelleries, drinking, smoking, foul odour, drive the other partner away and the offended (or say aggrieved) person is obliged to seek sex satisfaction with someone else, at some other place.
Uncompromising, sticky, obsessive and unrelenting attitude, when decisions are forced upon others and no importance is accorded to other person's sentiments.
Here, the other person suffers.
Over-exertion and heavy work-load, when no credit is given for a good work performed.
Lack of sleep and proper restless of job, some dear and near one, property income or gain.
Terrible worry, hurry and scurry of life, when reasonable comfort and mental and physical relaxations are sacrificed for the sake of earning easy & quick money or fame, or even approbation.
Some temporary/permanent physical infirmity
Lack/absence of a sincere, sympathetic and receptive confident
Too much brooding over certain events in life which defy any instant or distant solution
Fear of any kind.
Apprehension about imaginary happenings/losses
How to Get Rid of Insomnia
Anaemia, indigestion and lack of blood circulation or depraved blood supply to all the body organs are the three main causative factors that trigger insomnia and all such situations can be easily rectified without much effort. Following measures will mitigate the wrongs done by the said three factors, if not totally eliminate them.
• Take light diet (consisting of 1-2 chappatis/loaves), curd, salads, pulses, seasonal vegetables, some clarified butter), at least 2 hours prior to retiring to bed.
• Take a glassful of milk-half an hour before finally retiring to bed.
• Lukewarm water foot-bath or oil massage on head, temples, forehead, and cervical portion will induce sound sleep.
• If possible and when health permits, have a bath before going to bed-using cold shower bath in the summer and lukewarm water in cold weather.
• Use very comfortable and cushioned bed, keeping
• Your head slightly higher—your body sliding gradually towards your feet, provided it is not contrary to medical advice.
If light is necessary use a zero watt bulb of blue colour. Let in fresh air but avoid exposure of any type. If you use too heavy clothes during summer but lighter ones in winter, you cannot sleep. Hence, use clothes, sheets etc. according to weather conditions. Avoid using ACs/Coolers/Room blowers at full pitch.
• Avoid taking any sleeping pills, liquors, opium,
• Narcotics and, if you are a habitual user, taper down the dose and finally abandon
• A stroll in the evening, after taking dinner, is an excellent tonic for inducing sleep but when too tired, the same may be avoided.
It is claimed by experts that if your perform 'Vajraasana3, 60-90 minutes after taking dinner, it will digest food, improve circulation and pacify agitated nerves, thereby enabling you to enjoy a sound, reposeful and refreshing sleep.
Try to wriggle yourself out of the cobweb of disturbing problems. If you succeed in whiling away your day-to-day problems, of whatever etiology, you may not need any other help to get rid of insomnia.
If you are under treatment of a doctor, better seek his expert opinion and guidance -with regard to tapering of dose, dietary modifications and other regimen but do not use your discretion in this regard. Sleeplessness is caused by some compelling factor and, when the contributory cause has been eliminated, there may not be any need of taking medicines—even a slight modification in dietary regimen will suffice.
Anemia: Home remedies to prevent
Anemia Symptoms
Because a low red blood cell count decreases oxygen delivery to every tissue in the body, anemia may cause a variety of signs and symptoms. It can also make almost any other underlying medical condition worse. If anemia is mild, it may not cause any symptoms. If anemia is slowly ongoing (chronic), the body may adapt and compensate for the change; in this case there may not be any symptoms until the anemia becomes more severe.
Here are some effective home remedies to treat:
1. Mix together two teaspoons each of honey, lemon juice and gooseberry juice. Add a cup of water and d rink on an empty stomach.
2. Mix a tablespoon of gooseberry juice with a ripe, mashed banana. Consume this thrice a day.
3 Extract juice from an orange. Mix it with a mashed banana. Take this twice daily.
4. A banana taken with a tablespoon of honey does wonders to cure one of anemia.
5. Drink a cup apple juice on an empty stomach in the morning, and once before going to bed.
6. Beetroot juice combined with apple juice is an excellent remedy for anemia.
7. Mash banana and curd and a little sugar to it. Beat well. Take once a daily and eat for a month.
8. Soak a teaspoon of fenugreek in a cup of water overnight. Drink the water and eat the seeds.
9. A teaspoon of the juice from raw turmeric, mixed with honey, should be taken every day for the treatment of this condition.
FDA warns of risk of anemia drugs
Medications given to treat anemia in kidney and cancer patients greatly increase the risk of cardiovascular problems and need to be used more conservatively, the Food and Drug Administration has said.
The medicines, known as Erythropoiesis-Stimulating Agents (ESA) are approved to treat anemia resulting from Chronic Kidney Disease, chemotherapy and other conditions. But clinical trials have showed an increased risk of heart attacks, thrombosis and strokes when the drugs are given at high enough levels to get a normal blood hemoglobin level. Additionally, ESAs also do not improve quality of life, fatigue or patient well-being, the FDA stated Friday.
“Healthcare practitioners should carefully consider when to begin treatment with an ESA and actively monitor dosing in patients with chronic kidney disease, keeping in mind the increased risk for serious cardiovascular events, and should talk to their patients about these potential risks,” said John Jenkins, M.D., director of the Office of New Drugs in the FDA's Center for Drug Evaluation and Research. “The goal is to individualize therapy and use the lowest ESA dose possible to reduce the need for red blood cell transfusions.”
In addition to the side effects, critics charge that these medicines were the single biggest drug expense in the federal Medicare program, costing the federal government more than $60 billion since they debuted in 1989, The New York Times reported. “Sixty billion dollars have gone out the window on these drugs, and what do we have to show for it?” Dennis Cotter, president of Medical Technology and Practice Patterns, a nonprofit health policy research institute in Bethesda, MD, asked rhetorically in The Times.
The medicines, known as Erythropoiesis-Stimulating Agents (ESA) are approved to treat anemia resulting from Chronic Kidney Disease, chemotherapy and other conditions. But clinical trials have showed an increased risk of heart attacks, thrombosis and strokes when the drugs are given at high enough levels to get a normal blood hemoglobin level. Additionally, ESAs also do not improve quality of life, fatigue or patient well-being, the FDA stated Friday.
“Healthcare practitioners should carefully consider when to begin treatment with an ESA and actively monitor dosing in patients with chronic kidney disease, keeping in mind the increased risk for serious cardiovascular events, and should talk to their patients about these potential risks,” said John Jenkins, M.D., director of the Office of New Drugs in the FDA's Center for Drug Evaluation and Research. “The goal is to individualize therapy and use the lowest ESA dose possible to reduce the need for red blood cell transfusions.”
In addition to the side effects, critics charge that these medicines were the single biggest drug expense in the federal Medicare program, costing the federal government more than $60 billion since they debuted in 1989, The New York Times reported. “Sixty billion dollars have gone out the window on these drugs, and what do we have to show for it?” Dennis Cotter, president of Medical Technology and Practice Patterns, a nonprofit health policy research institute in Bethesda, MD, asked rhetorically in The Times.
Postmenopausal women at higher risk of suffering from anemia
A new study claims that postmenopausal women are at greater risk of suffering from anemia, if they do not maintain a healthy diet rich in certain vitamins and nutrients.
They added, women can lessen their chances of suffering from anemia by taking enough of vitamin B12, iron, protein, folate, nutrients from red meat and vitamin C in their diet.
Women who are deficient in at least three of aforementioned vitamins are more likely to suffer from anemia as compared to those who either are deficient in one or none at all, added researchers.
While commenting on the study findings, lead researcher associate professor of nutritional sciences from the University of Arizona in Tucson, Cynthia A. Thomson, in her press release, “Anemia, particularly iron deficiency, has been associated with reduced capacity for physical work and physical inactivity, injury related to falls and hospitalizations, making this an important health-care concern in the aging."
Anemia is a condition in which production of healthy red blood cells (responsible for providing oxygen to body tissues) decreases significantly. It can result into chronic fatigue, dizziness, headaches etc.
About research
To arrive at this conclusion, the researchers thoroughly analyzed nutritional data collected after interviewing nearly 80,000 postmenopausal women.
Nearly 5.5 percent women in the study were found to be anemic. Researchers found that women who were deficient in three nutrients simultaneously were 44 percent more at risk of suffering from anemia.
Being deficient in only one nutrient raised women's chances of suffering from anemia by 21 percent.
Researchers were startled to find that deficiency of three different nutrients were higher among Asians/Pacific Islander (14.6 percent), Afro-American (15.3 percent) and Hispanics (16.3 percent) women as compared to 7.4 percent white women.
Apparently this could be due to the fact that white women took more nutrients from their red meat/nutrient-fortified cereal as compared to women from other ethnic groups.
Taking mineral supplements and multi-vitamins does nothing to decrease the risk, added researchers.
Women need to be aware of their diets
As per medical experts, severe anemia, if goes unchecked, can also result into death, hence, women should pay special attention towards their diet.
"Efforts to identify anemia that may be responsive to modifiable factors, such as diet to improve health outcomes, are needed. Additional efforts to regularly evaluate postmenopausal women for anemia should be considered,” concluded study authors.
The study findings are scheduled to be published in the upcoming April 2011 issue of the ‘Journal of the American Dietetic Association.’
source: themedguru
How To Raise Your Hemoglobin Levels Naturally?
Reduction in levels of hemoglobin is called anemia. It is very common in under developed and developing countries. The most common cause for anemia is under-nourishment. The diet required to replenish stores is usually not taken. Second most common cause is loss of blood e.g. during menstruation, injury and bleeding piles. Third cause of anemia is worm infestation (hookworm, pin worm, roundworm and tape worm). These worms feed on supply of blood and vitamins we take.
Foods to increase Hemoglobin
To increase hemoglobin level, the diet is the most important thing. A modified diet rich in vitamin B12, folate and iron is essential for the rapid rise in hemoglobin level.
Folate is commonly present in liver, kidney, spinach, cabbage, yeast, nuts and fruits. Vitamin B12 is exclusively present in foods of animal origin. Meat, liver, eggs, dairy products contain adequate amount of the vitamin B12.
Vegetable sources do not contain vitamin B12.
Iron is present in red meat, liver, egg yolk, green leafy vegetables, dry fruits, jaggery, brown bread, unpolished rice. Milk is a poor source of iron.
Other foods which can help are bananas, black grapes, plums, strawberries, raisins, carrots, radish, celery, tomatoes, beets, almonds, soyabeans, fenugreek seeds etc.
source: tandurust
Hereditary Causes and Treatment of Anemia
There are many reasons people develop anemia. Sometimes people become anemic if they have a chronic condition, such as cancer or kidney disease. For these patients, treating anemia is part of the overall care of their condition.
Other times, anemia can be caused by a hereditary condition that occurs because of small variations in a patient’s genes. Genes are located in every cell and are instructions that your cells follow to complete different processes that take place in the human body. Each person receives a copy of genes from their parents and sometimes variations or flaws in the genes can be passed along as well. In this case, some very specific flaws that are inherited from your parents can lead to anemia.
Making Red Blood Cells
Like many processes in the human body, making new red blood cells is very complicated with many steps. Because it is so complex, there are many things that can go wrong. When something in the process of making new red blood cells (called erythropoiesis) goes wrong, a patient can develop anemia.
How your body uses the iron and vitamins it acquires from food is also an important aspect of making red blood cells. When the body cannot absorb iron or certain vitamins properly or is unable to incorporate them into hemoglobin, red blood cells may not be created fast enough or created at all. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen from the lungs to all parts of the body. Also, doctors determine if a patient is anemic by measuring their hemoglobin level.
Anemia Symptoms and Resources
Anemia is a condition that can make you feel tired, fatigued, weak, dizzy, irritable, short of breath or depressed. With anemia, you may also have pale skin, brittle nails, chest pain, a coldness in your hands or feet, or a rapid heartbeat. Some people with anemia also have a desire to eat ice or other peculiar things, experience sexual dysfunction, or have trouble concentrating or performing mental tasks.
The National Anemia Action Council focuses on anemia that is caused by iron deficiency, vitamin deficiency, aging, surgery or by acquired chronic conditions like cancer, diabetes, inflammatory bowel disease, kidney disease, heart disease, hepatitis C, HIV/AIDS, and rheumatoid arthritis. These types of anemia are known as iron deficiency anemia, vitamin deficiency anemia and anemia of chronic disease. NAAC has numerous resources devoted to these types of anemia, including basic education in our Information Handouts, Anemia FAQs, Symptoms Quiz, and the new interactive tutorial Blood and Bone Marrow Basics. For a more in-depth look at anemia as it relates to specific conditions, check out some of the other Feature Articles.
Several other organizations listed in our More Health Resources section deal with many types of anemia that are caused by hereditary conditions. Some of these hereditary conditions are briefly described below.
Hereditary Conditions Causing Anemia
Certain hereditary variations in a person’s genes can lead to incorrect or decreased production of red blood cells. This can cause red blood cells to not last as long in the blood, not be as effective transporting oxygen from the lungs to different parts of the body, or not be created at all. Listed below are some hereditary conditions that cause anemia through various genetic mechanisms.
Sickle Cell Anemia is a disease where the body makes red blood cells that are shaped like a crescent moon or the letter “C” when they are depleted of oxygen. These abnormally-shaped cells do not flow as well through the circulatory system and last for only 10-20 days compared to about 120 days for healthy, normal-shaped red blood cells. The body continually makes new red blood cells, but anemia develops because sickle cells do not last very long. Sickle cell disease affects 72,000 people in the United States and is most common in people of African descent.
Thalassemia is a condition where the body does not properly construct one of the proteins needed to make hemoglobin. Moderate to severe anemia can occur if one of these proteins is defective or missing. Hemoglobin is located in red blood cells and transports oxygen from the lungs to muscles and organs throughout the body. Thalassemia can be treated with transfusions and iron chelation therapy and may be curable with a bone marrow transplant.
Fanconi Anemia is a condition in which the bone marrow can fail to produce red blood cells, white blood cells and platelets. The lack of enough red blood cells will lead to anemia, but can be treated with a bone marrow transplant. These patients are also often born with a variety of other genetic defects and are also very susceptible to developing cancer, including acute myelogenous leukemia (AML), head and neck, esophageal, gastrointestinal, vulvar and anal cancers. Diagnosis of Fanconi Anemia normally occurs in children 10-15 years old, but may be first recognized in adults.
Diamond Blackfan anemia is a condition in which the bone marrow fails to produce enough red blood cells. The condition usually develops at an early age, with most patients being diagnosed within the first year of life. Several types of facial or physical abnormalities can also be present in patients with the condition. Diamond Blackfan anemia is also referred to as congenital pure red cell aplasia, congenital hypoplastic anemia and Aase syndrome.
Shwachman Diamond syndrome is a rare condition affecting the digestive enzymes in the pancreas and the creation of blood cells in the bone marrow. Decreased red blood cell production and white blood cell production can lead to anemia and recurrent infections, respectively. Infants four to six months often begin to show symptoms, including feeding problems and slowed growth. The condition is similar to cystic fibrosis and is usually diagnosed within the first few years of life.
Red cell membrane disorders can cause instability in cellular structure, resulting in abnormally shaped red blood cells. The most common form is hereditary spherocytosis. Characterized by round or sphere-shaped red blood cells, hereditary spherocytosis is the most common inherited anemia in people of northern European descent.
Hereditary elliptocytosis, a different form which can vary widely in severity, causes patients to have a large number of oval or elliptical-shaped red blood cells. This form is common in people of African and Mediterranean descent.6 Hereditary stomatocytosis is a third form of these disorders that can cause patients to have mouth-shaped red blood cells which do not properly transport sodium and potassium in and out of the cell. Some patients with these membrane disorders may not have noticeable symptoms.
G6PD deficiency is a hereditary condition in which the body cannot produce enough glucose-6-phosphate dehydrogenase (G6PD), an important enzyme that protects red blood cells from destruction by certain chemicals or drugs. G6PD deficiency is the most common enzyme deficiency in the world, affecting more than 400 million people usually of African, Asian, Mediterranean or Middle-Eastern descent. Patients with this condition often develop anemia that is triggered by an infection or an exposure to toxins, drugs or chemicals.
Hereditary hemorrhagic telangiectasia is a condition where patients are predisposed to bleeding at places where their arteries and veins are improperly connected. Due to significant blood loss or reoccurring bleeding, often from the stomach or intestines, patients can develop anemia.
Additional Hereditary Conditions
Although this article listed some of the more common hereditary conditions that can lead to anemia, patients with any condition which can decrease the function of the bone marrow, red blood cell production or the ability of the digestive system to absorb vitamin B12 or iron are at-risk of developing anemia. Other notable conditions and classes of conditions which can affect patients in this manner include dyskeratosis congenita, congenital dyserythropoietic anemias, and congenital B12 malabsorption syndromes.
Although not a cause of anemia, hemochromatosis is an iron-related hereditary condition in which the body absorbs more iron from the food than it needs. Because there is no way for the body to get rid of the excess iron, it is stored in various organs like the liver, heart and pancreas. If untreated, the increasing levels of stored iron can cause organs to become diseased. Also known as iron overload disease, hemochromatosis is one of the most common genetic disorders in the United States.10 The Iron Disorders Institute, which specializes in hemochromatosis, is the spotlight organization for the July 2009 issue of Anemia Watch.
Screening and Treatment of Hereditary Anemias
Because hereditary anemia is determined by the make-up of your genes, there are various ways in which your doctor can detect if you have one of these genetic variations. The presence of anemia, as determined by a below normal hemoglobin level, is one important indicator that you may have a hereditary or chronic condition that causes anemia. These methods of detection are usually referred to as genetic screening tests and involve precise analysis of the structure of your genes, but are not available yet for all hereditary anemias. To help your doctor diagnose your anemia, be sure to tell him or her if your family has a history of any of the hereditary conditions listed above. This history can indicate if you are at-risk for carrying one of the genetic variations which can cause anemia.
There are many different types of treatment for hereditary anemias which counteract the body’s inability to sustain healthy levels of red blood cells and minimize the anemia-related symptoms patients often experience. If you are diagnosed with a hereditary anemia, close communication with your doctor will help him or her provide additional information and the treatment that is best for you based on what is causing the anemia.
source: anemia.org
Other times, anemia can be caused by a hereditary condition that occurs because of small variations in a patient’s genes. Genes are located in every cell and are instructions that your cells follow to complete different processes that take place in the human body. Each person receives a copy of genes from their parents and sometimes variations or flaws in the genes can be passed along as well. In this case, some very specific flaws that are inherited from your parents can lead to anemia.
Making Red Blood Cells
Like many processes in the human body, making new red blood cells is very complicated with many steps. Because it is so complex, there are many things that can go wrong. When something in the process of making new red blood cells (called erythropoiesis) goes wrong, a patient can develop anemia.
How your body uses the iron and vitamins it acquires from food is also an important aspect of making red blood cells. When the body cannot absorb iron or certain vitamins properly or is unable to incorporate them into hemoglobin, red blood cells may not be created fast enough or created at all. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen from the lungs to all parts of the body. Also, doctors determine if a patient is anemic by measuring their hemoglobin level.
Anemia Symptoms and Resources
Anemia is a condition that can make you feel tired, fatigued, weak, dizzy, irritable, short of breath or depressed. With anemia, you may also have pale skin, brittle nails, chest pain, a coldness in your hands or feet, or a rapid heartbeat. Some people with anemia also have a desire to eat ice or other peculiar things, experience sexual dysfunction, or have trouble concentrating or performing mental tasks.
The National Anemia Action Council focuses on anemia that is caused by iron deficiency, vitamin deficiency, aging, surgery or by acquired chronic conditions like cancer, diabetes, inflammatory bowel disease, kidney disease, heart disease, hepatitis C, HIV/AIDS, and rheumatoid arthritis. These types of anemia are known as iron deficiency anemia, vitamin deficiency anemia and anemia of chronic disease. NAAC has numerous resources devoted to these types of anemia, including basic education in our Information Handouts, Anemia FAQs, Symptoms Quiz, and the new interactive tutorial Blood and Bone Marrow Basics. For a more in-depth look at anemia as it relates to specific conditions, check out some of the other Feature Articles.
Several other organizations listed in our More Health Resources section deal with many types of anemia that are caused by hereditary conditions. Some of these hereditary conditions are briefly described below.
Hereditary Conditions Causing Anemia
Certain hereditary variations in a person’s genes can lead to incorrect or decreased production of red blood cells. This can cause red blood cells to not last as long in the blood, not be as effective transporting oxygen from the lungs to different parts of the body, or not be created at all. Listed below are some hereditary conditions that cause anemia through various genetic mechanisms.
Sickle Cell Anemia is a disease where the body makes red blood cells that are shaped like a crescent moon or the letter “C” when they are depleted of oxygen. These abnormally-shaped cells do not flow as well through the circulatory system and last for only 10-20 days compared to about 120 days for healthy, normal-shaped red blood cells. The body continually makes new red blood cells, but anemia develops because sickle cells do not last very long. Sickle cell disease affects 72,000 people in the United States and is most common in people of African descent.
Thalassemia is a condition where the body does not properly construct one of the proteins needed to make hemoglobin. Moderate to severe anemia can occur if one of these proteins is defective or missing. Hemoglobin is located in red blood cells and transports oxygen from the lungs to muscles and organs throughout the body. Thalassemia can be treated with transfusions and iron chelation therapy and may be curable with a bone marrow transplant.
Fanconi Anemia is a condition in which the bone marrow can fail to produce red blood cells, white blood cells and platelets. The lack of enough red blood cells will lead to anemia, but can be treated with a bone marrow transplant. These patients are also often born with a variety of other genetic defects and are also very susceptible to developing cancer, including acute myelogenous leukemia (AML), head and neck, esophageal, gastrointestinal, vulvar and anal cancers. Diagnosis of Fanconi Anemia normally occurs in children 10-15 years old, but may be first recognized in adults.
Diamond Blackfan anemia is a condition in which the bone marrow fails to produce enough red blood cells. The condition usually develops at an early age, with most patients being diagnosed within the first year of life. Several types of facial or physical abnormalities can also be present in patients with the condition. Diamond Blackfan anemia is also referred to as congenital pure red cell aplasia, congenital hypoplastic anemia and Aase syndrome.
Shwachman Diamond syndrome is a rare condition affecting the digestive enzymes in the pancreas and the creation of blood cells in the bone marrow. Decreased red blood cell production and white blood cell production can lead to anemia and recurrent infections, respectively. Infants four to six months often begin to show symptoms, including feeding problems and slowed growth. The condition is similar to cystic fibrosis and is usually diagnosed within the first few years of life.
Red cell membrane disorders can cause instability in cellular structure, resulting in abnormally shaped red blood cells. The most common form is hereditary spherocytosis. Characterized by round or sphere-shaped red blood cells, hereditary spherocytosis is the most common inherited anemia in people of northern European descent.
Hereditary elliptocytosis, a different form which can vary widely in severity, causes patients to have a large number of oval or elliptical-shaped red blood cells. This form is common in people of African and Mediterranean descent.6 Hereditary stomatocytosis is a third form of these disorders that can cause patients to have mouth-shaped red blood cells which do not properly transport sodium and potassium in and out of the cell. Some patients with these membrane disorders may not have noticeable symptoms.
G6PD deficiency is a hereditary condition in which the body cannot produce enough glucose-6-phosphate dehydrogenase (G6PD), an important enzyme that protects red blood cells from destruction by certain chemicals or drugs. G6PD deficiency is the most common enzyme deficiency in the world, affecting more than 400 million people usually of African, Asian, Mediterranean or Middle-Eastern descent. Patients with this condition often develop anemia that is triggered by an infection or an exposure to toxins, drugs or chemicals.
Hereditary hemorrhagic telangiectasia is a condition where patients are predisposed to bleeding at places where their arteries and veins are improperly connected. Due to significant blood loss or reoccurring bleeding, often from the stomach or intestines, patients can develop anemia.
Additional Hereditary Conditions
Although this article listed some of the more common hereditary conditions that can lead to anemia, patients with any condition which can decrease the function of the bone marrow, red blood cell production or the ability of the digestive system to absorb vitamin B12 or iron are at-risk of developing anemia. Other notable conditions and classes of conditions which can affect patients in this manner include dyskeratosis congenita, congenital dyserythropoietic anemias, and congenital B12 malabsorption syndromes.
Although not a cause of anemia, hemochromatosis is an iron-related hereditary condition in which the body absorbs more iron from the food than it needs. Because there is no way for the body to get rid of the excess iron, it is stored in various organs like the liver, heart and pancreas. If untreated, the increasing levels of stored iron can cause organs to become diseased. Also known as iron overload disease, hemochromatosis is one of the most common genetic disorders in the United States.10 The Iron Disorders Institute, which specializes in hemochromatosis, is the spotlight organization for the July 2009 issue of Anemia Watch.
Screening and Treatment of Hereditary Anemias
Because hereditary anemia is determined by the make-up of your genes, there are various ways in which your doctor can detect if you have one of these genetic variations. The presence of anemia, as determined by a below normal hemoglobin level, is one important indicator that you may have a hereditary or chronic condition that causes anemia. These methods of detection are usually referred to as genetic screening tests and involve precise analysis of the structure of your genes, but are not available yet for all hereditary anemias. To help your doctor diagnose your anemia, be sure to tell him or her if your family has a history of any of the hereditary conditions listed above. This history can indicate if you are at-risk for carrying one of the genetic variations which can cause anemia.
There are many different types of treatment for hereditary anemias which counteract the body’s inability to sustain healthy levels of red blood cells and minimize the anemia-related symptoms patients often experience. If you are diagnosed with a hereditary anemia, close communication with your doctor will help him or her provide additional information and the treatment that is best for you based on what is causing the anemia.
source: anemia.org
Alzheimer's Disease May Increase Risk of Anemia and Seizures
- Global Impact Could Multiply As The Population Continues to Age -
HONOLULU, Having Alzheimer's disease may increase the risk of getting other potentially disabling health conditions, including seizures and anemia, according to new research presented today at the Alzheimer's Association International Conference on Alzheimer's Disease 2010 (AAICAD 2010) in Honolulu, HI.
"Alzheimer's disease is a global health crisis with devastating effects on individuals, families, and national healthcare systems," said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's Association. "If, in fact, Alzheimer's also increases risk of other disabling conditions, then its impact may be more devastating than we've envisioned as the global population ages and as more countries become westernized in their habits and lifestyles."
According to the 2009 World Alzheimer Report from Alzheimer's Disease International, a London-based nonprofit, international federation of 71 national Alzheimer organizations including the Alzheimer's Association, the number of people with Alzheimer's or another dementia, currently 35 million, is expected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.
Worldwide, the economic cost of dementia has been estimated as $315 billion annually. (Wimo, et al. "An Estimate of the Total Worldwide Societal Costs of Dementia in 2005." Alzheimer's & Dementia: The Journal of the Alzheimer's Association. Vol. 3, Issue 2, April 2007.)
Alzheimer's is Associated with Increased Incidence of Seizures
Some small studies have shown Alzheimer's to be a risk factor for seizures. H. Michael Arrighi, PhD, of Janssen Alzheimer Immunotherapy Research & Development; Nicole Baker, MPH, Pfizer; and colleagues conducted an observational study to estimate the incidence rate of seizures among a large cohort of people with Alzheimer's. The researchers used anonymized electronic medical records from nearly 400 primary medical practices in the United Kingdom. The study population included 14,838 people with Alzheimer's aged 50 years or older and a comparison cohort of 14,838 randomly-selected, age- and sex-matched patients without Alzheimer's. People with Alzheimer's were followed for an average of 2.3 years; non-Alzheimer's patients were followed for an average of 3.4 years.
Over that time period, the researchers found that the rate of seizures, per 1,000 people per year, was 9.1 among patients with Alzheimer's disease compared with 1.4 for those without Alzheimer's – an incidence rate that was 6.4 times higher. In addition, they found that the incidence rate of seizures was highest among the youngest Alzheimer's patients, and that it decreased with age. Incidence among non-Alzheimer's patients increased slightly with age.
"The increased risk of seizures among patients with Alzheimer's disease was seen in all age groups, but there was a substantial increase among the youngest patients. It is especially important for these patients and their caregivers to be aware of this risk," Baker said.
"The connection between Alzheimer's and seizures provides additional avenues for research into the basic biology of both diseases, and possibly interventions and therapies to respond to the overall impact of Alzheimer's disease" Arrighi said.
Alzheimer's is Associated with Lower Hemoglobin Levels and Anemia
Studies suggest that iron accumulates in the tau tangles in the brains of people with Alzheimer's, and that overall levels of iron are elevated in both Alzheimer's and Mild Cognitive Impairment (MCI) brains. However, it is not clear from the scientific literature if this altered brain iron profile is reflected in plasma iron levels.
Noel Faux, PhD, of the Mental Health Research Institute, Parkville, Australia, and colleagues examined hemoglobin, iron and other blood-based measurements in the 1,112 participants (768 healthy controls, 133 MCI, 211 Alzheimer's) of the Australian Imaging Biomarkers and Lifestyle (AIBL) study of Ageing. Participants also completed questionnaires on diet and medication intake (including supplements). Results were then correlated with measures of short-term, long-term and total memory, and global cognition.
The researchers found that people with Alzheimer's in the study had significantly lower levels of hemoglobin, mean cell hemoglobin concentration (MCHC), and packed cell volume compared with healthy controls, after adjustment for age and gender. Consistent with these data, the erythrocyte sedimentation rate (ESR) was significantly higher in Alzheimer's compared to healthy controls.
Participants with anemia in the study were found to have an increased risk of Alzheimer's (odds ratio: 2.56). And people with Alzheimer's in the study were found to have an increased risk of being anemic (odds ratio: 2.61). Self reported iron intake was not different in the two groups.
"In our population, we found that people with Alzheimer's disease were more likely to be anemic, and this was not explained by dietary iron deficiency," Faux said. "This suggests that hemoglobin production is deficient in Alzheimer's patients."
"Alzheimer's had not previously been recognized as a risk factor for anemia, which is a common clinical problem for the elderly and can contribute to problems such as heart failure and renal failure," Faux continued. "The cause of anemia in Alzheimer's is still uncertain, but we speculate that Alzheimer's is a disease that affects both brain and blood. We are currently investigating this intriguing possibility."
About AAICAD
The Alzheimer's Association International Conference on Alzheimer's Disease (AAICAD) is the world's largest conference of it's kind, bringing together researchers from around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Alzheimer's Association's research program, AAICAD serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
About the Alzheimer's Association
The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's.
source: prnewswire
HONOLULU, Having Alzheimer's disease may increase the risk of getting other potentially disabling health conditions, including seizures and anemia, according to new research presented today at the Alzheimer's Association International Conference on Alzheimer's Disease 2010 (AAICAD 2010) in Honolulu, HI.
"Alzheimer's disease is a global health crisis with devastating effects on individuals, families, and national healthcare systems," said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer's Association. "If, in fact, Alzheimer's also increases risk of other disabling conditions, then its impact may be more devastating than we've envisioned as the global population ages and as more countries become westernized in their habits and lifestyles."
According to the 2009 World Alzheimer Report from Alzheimer's Disease International, a London-based nonprofit, international federation of 71 national Alzheimer organizations including the Alzheimer's Association, the number of people with Alzheimer's or another dementia, currently 35 million, is expected to nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.
Worldwide, the economic cost of dementia has been estimated as $315 billion annually. (Wimo, et al. "An Estimate of the Total Worldwide Societal Costs of Dementia in 2005." Alzheimer's & Dementia: The Journal of the Alzheimer's Association. Vol. 3, Issue 2, April 2007.)
Alzheimer's is Associated with Increased Incidence of Seizures
Some small studies have shown Alzheimer's to be a risk factor for seizures. H. Michael Arrighi, PhD, of Janssen Alzheimer Immunotherapy Research & Development; Nicole Baker, MPH, Pfizer; and colleagues conducted an observational study to estimate the incidence rate of seizures among a large cohort of people with Alzheimer's. The researchers used anonymized electronic medical records from nearly 400 primary medical practices in the United Kingdom. The study population included 14,838 people with Alzheimer's aged 50 years or older and a comparison cohort of 14,838 randomly-selected, age- and sex-matched patients without Alzheimer's. People with Alzheimer's were followed for an average of 2.3 years; non-Alzheimer's patients were followed for an average of 3.4 years.
Over that time period, the researchers found that the rate of seizures, per 1,000 people per year, was 9.1 among patients with Alzheimer's disease compared with 1.4 for those without Alzheimer's – an incidence rate that was 6.4 times higher. In addition, they found that the incidence rate of seizures was highest among the youngest Alzheimer's patients, and that it decreased with age. Incidence among non-Alzheimer's patients increased slightly with age.
"The increased risk of seizures among patients with Alzheimer's disease was seen in all age groups, but there was a substantial increase among the youngest patients. It is especially important for these patients and their caregivers to be aware of this risk," Baker said.
"The connection between Alzheimer's and seizures provides additional avenues for research into the basic biology of both diseases, and possibly interventions and therapies to respond to the overall impact of Alzheimer's disease" Arrighi said.
Alzheimer's is Associated with Lower Hemoglobin Levels and Anemia
Studies suggest that iron accumulates in the tau tangles in the brains of people with Alzheimer's, and that overall levels of iron are elevated in both Alzheimer's and Mild Cognitive Impairment (MCI) brains. However, it is not clear from the scientific literature if this altered brain iron profile is reflected in plasma iron levels.
Noel Faux, PhD, of the Mental Health Research Institute, Parkville, Australia, and colleagues examined hemoglobin, iron and other blood-based measurements in the 1,112 participants (768 healthy controls, 133 MCI, 211 Alzheimer's) of the Australian Imaging Biomarkers and Lifestyle (AIBL) study of Ageing. Participants also completed questionnaires on diet and medication intake (including supplements). Results were then correlated with measures of short-term, long-term and total memory, and global cognition.
The researchers found that people with Alzheimer's in the study had significantly lower levels of hemoglobin, mean cell hemoglobin concentration (MCHC), and packed cell volume compared with healthy controls, after adjustment for age and gender. Consistent with these data, the erythrocyte sedimentation rate (ESR) was significantly higher in Alzheimer's compared to healthy controls.
Participants with anemia in the study were found to have an increased risk of Alzheimer's (odds ratio: 2.56). And people with Alzheimer's in the study were found to have an increased risk of being anemic (odds ratio: 2.61). Self reported iron intake was not different in the two groups.
"In our population, we found that people with Alzheimer's disease were more likely to be anemic, and this was not explained by dietary iron deficiency," Faux said. "This suggests that hemoglobin production is deficient in Alzheimer's patients."
"Alzheimer's had not previously been recognized as a risk factor for anemia, which is a common clinical problem for the elderly and can contribute to problems such as heart failure and renal failure," Faux continued. "The cause of anemia in Alzheimer's is still uncertain, but we speculate that Alzheimer's is a disease that affects both brain and blood. We are currently investigating this intriguing possibility."
About AAICAD
The Alzheimer's Association International Conference on Alzheimer's Disease (AAICAD) is the world's largest conference of it's kind, bringing together researchers from around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Alzheimer's Association's research program, AAICAD serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.
About the Alzheimer's Association
The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's.
source: prnewswire
Key signs and symptoms of vitamin deficiency anemia?
The human body needs vitamins and nutrients which are found in most foods. Healthy nutrition is required for many purposes, including producing fit red blood cells. When the body is underprovided in certain key vitamins, a type of anemia called vitamin deficiency anemia can develop.
Anemia, also spelled anaemia and anæmia, comes from Ancient Greek αvαιμία anaimia, meaning lack of blood. It is a decrease in the normal number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. In vitamin deficiency anemia, the body does not make enough red blood cells. Red blood cells carry oxygen from the lungs to all parts of the body. Anemia leads to hypoxia which is a lack of oxygen in organs. Because all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences.
Vitamin deficiency anemia reduces the number of healthy red blood cells; as a result the body cannot get all the oxygen it needs to feel energized. This can also lead to other health problems, such as memory difficulties and tingling in hands and feet.
Vitamin deficiency anemia can usually be corrected with supplements and changes in diet.
What are the signs and symptoms of vitamin deficiency anemia?
The patient feels and describes a symptom, while other people, including the physician or nurse detect a sign. For example, headache may be a symptom while dilated pupils may be a sign.
Anemia goes undetected in many people, and symptoms can be minor or vague. The signs and symptoms can be related to the anemia itself, or the underlying cause. Most commonly, people with anemia report non-specific symptoms of a feeling of weakness, or fatigue, general malaise and sometimes poor concentration.
Vitamin deficiency anemia can result in:
* Diarrhea
* Fatigue
* Irritability
* Mental confusion or forgetfulness
* Muscle weakness
* Numbness or tingling in hands and feet
* Pale or yellowish skin
* Sore mouth and tongue
* Trembling movements
* Weight loss
Vitamin deficiencies usually develop slowly, over several months to years. Vitamin deficiency symptoms may be subtle at first, but they tend to increase as the deficiency worsens.
More Information
Anemia, also spelled anaemia and anæmia, comes from Ancient Greek αvαιμία anaimia, meaning lack of blood. It is a decrease in the normal number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. In vitamin deficiency anemia, the body does not make enough red blood cells. Red blood cells carry oxygen from the lungs to all parts of the body. Anemia leads to hypoxia which is a lack of oxygen in organs. Because all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences.
Vitamin deficiency anemia reduces the number of healthy red blood cells; as a result the body cannot get all the oxygen it needs to feel energized. This can also lead to other health problems, such as memory difficulties and tingling in hands and feet.
Vitamin deficiency anemia can usually be corrected with supplements and changes in diet.
What are the signs and symptoms of vitamin deficiency anemia?
The patient feels and describes a symptom, while other people, including the physician or nurse detect a sign. For example, headache may be a symptom while dilated pupils may be a sign.
Anemia goes undetected in many people, and symptoms can be minor or vague. The signs and symptoms can be related to the anemia itself, or the underlying cause. Most commonly, people with anemia report non-specific symptoms of a feeling of weakness, or fatigue, general malaise and sometimes poor concentration.
Vitamin deficiency anemia can result in:
* Diarrhea
* Fatigue
* Irritability
* Mental confusion or forgetfulness
* Muscle weakness
* Numbness or tingling in hands and feet
* Pale or yellowish skin
* Sore mouth and tongue
* Trembling movements
* Weight loss
Vitamin deficiencies usually develop slowly, over several months to years. Vitamin deficiency symptoms may be subtle at first, but they tend to increase as the deficiency worsens.
More Information
FDA escalates warnings about drugs to counter anemia, chemo fatigue
Acting on growing safety concerns, the FDA on Tuesday ordered strict new procedures on the prescribing and dispensing of medication that treats anemia in cancer patients undergoing chemotherapy.
The new strictures ordered by the FDA affect a class of drugs called erythropoiesis-stimulating agencts, which rev up the production of red blood cells that are often depleted by cancer-fighting therapies, as well as certain drugs that treat HIV/AIDS. The drugs are sometimes given to surgical patients in an effort to reduce their need for blood transfusions and are prescribed to patients with chronic kidney disease, who often suffer anemia.
Marketed under the brand names Procrit, Epogen and Aranesp, these biologic agents can now be prescribed and dispensed only after hospitals and physicians prescribing them have certified that patients have been apprised of the drugs' risks. Several new studies have found that cancer patients and others taking this class of medications have had higher rates of tumor growth and of heart attack, heart failure, stroke or bloodclots than patients who are not on the medication. Compared with patients not on medication, patients taking the erythropoeisis-stimulating agents (or ESAs) overall have been found to die sooner as well.
The biotechnology company Amgen, whichs makes Aranesp, Epogen and Procrit (although Procrit is marketed by Johnson & Johnson Pharmaceuticals), is expected to establish a training program for physicians and hospitals wishing to prescribe any of the ESAs and to track data on their use.
The new policy follows by less than five weeks the publication of an editorial in the New England Journal of Medicine which outlines the welter of clinical trials that have turned up evidence for concern over the safety of ESAs. The editorial concludes that the medical community should reconsider its widespread use of these medications until clinical trials have established safer guidelines for their use. Among the authors of the editorial was Dr. Robert Temple, acting director of the FDA's office of drug evaluation.
The medications have been widely advertised to patients as a means of improving energy and quality of life during cancer treatment.
— Melissa Healy
SOURCE: latimesblogs.latimes
The new strictures ordered by the FDA affect a class of drugs called erythropoiesis-stimulating agencts, which rev up the production of red blood cells that are often depleted by cancer-fighting therapies, as well as certain drugs that treat HIV/AIDS. The drugs are sometimes given to surgical patients in an effort to reduce their need for blood transfusions and are prescribed to patients with chronic kidney disease, who often suffer anemia.
Marketed under the brand names Procrit, Epogen and Aranesp, these biologic agents can now be prescribed and dispensed only after hospitals and physicians prescribing them have certified that patients have been apprised of the drugs' risks. Several new studies have found that cancer patients and others taking this class of medications have had higher rates of tumor growth and of heart attack, heart failure, stroke or bloodclots than patients who are not on the medication. Compared with patients not on medication, patients taking the erythropoeisis-stimulating agents (or ESAs) overall have been found to die sooner as well.
The biotechnology company Amgen, whichs makes Aranesp, Epogen and Procrit (although Procrit is marketed by Johnson & Johnson Pharmaceuticals), is expected to establish a training program for physicians and hospitals wishing to prescribe any of the ESAs and to track data on their use.
The new policy follows by less than five weeks the publication of an editorial in the New England Journal of Medicine which outlines the welter of clinical trials that have turned up evidence for concern over the safety of ESAs. The editorial concludes that the medical community should reconsider its widespread use of these medications until clinical trials have established safer guidelines for their use. Among the authors of the editorial was Dr. Robert Temple, acting director of the FDA's office of drug evaluation.
The medications have been widely advertised to patients as a means of improving energy and quality of life during cancer treatment.
— Melissa Healy
SOURCE: latimesblogs.latimes
Thalassemia: An inherited form of anemia
Thalassemia is An inherited form of anemia occurring chiefly among people of Mediterranean descent, common among people of Italian, Greek, Middle Eastern Chinese, Asian and South East Asian descent. It is also caused by fault synthesis of part of the hemoglobin molecule.
It is characterized by defective production of hemoglobin that leads to underproduction and excessive destruction of red blood cells.
It is also a group of genetic blood disorders and is considered the most prevalent inherited genetic blood disorder in the world with over 300,000 cases worldwide.
Blood transfusions or bone marrow transplant are required for this condition.
The most severe form of this inherited blood disorder is Cooley’s anemia (beta thalasemia major).
It is characterized by defective production of hemoglobin that leads to underproduction and excessive destruction of red blood cells.
It is also a group of genetic blood disorders and is considered the most prevalent inherited genetic blood disorder in the world with over 300,000 cases worldwide.
Blood transfusions or bone marrow transplant are required for this condition.
The most severe form of this inherited blood disorder is Cooley’s anemia (beta thalasemia major).
Excellent diet source for an anemic patient
An anemia diet frequently consists of an iron-rich diet along with iron supplements. Absorption of iron from food is influenced by numerous factors. One significant factor being the form of the iron. Heme Iron, found in animal sources, is extremely available for absorption. Non-heme iron on the other hand, found in vegetable sources, is less obtainable. An anemia diet may include the following:
Anemia Diet containing Heme Iron
Excellent Sources Good Sources
• Clams
• Pork Liver
• Oysters
• Chicken Liver
• Mussels
• Beef Liver
• Beef
• Shrimp
• Sardines
• Turkey
Anemia Diet containing Non-Heme Iron
Excellent Sources Good Sources
• Enriched breakfast cereals
• Cooked beans and lentils
• Pumpkin seeds
• Blackstrap Molasses
• Canned beans
• Baked potato with skin
• Enriched pasta
• Cann
source: mdinfo
Anemia Diet containing Heme Iron
Excellent Sources Good Sources
• Clams
• Pork Liver
• Oysters
• Chicken Liver
• Mussels
• Beef Liver
• Beef
• Shrimp
• Sardines
• Turkey
Anemia Diet containing Non-Heme Iron
Excellent Sources Good Sources
• Enriched breakfast cereals
• Cooked beans and lentils
• Pumpkin seeds
• Blackstrap Molasses
• Canned beans
• Baked potato with skin
• Enriched pasta
• Cann
source: mdinfo
Expert Recommendations for Treating Anemia in Patients With Kidney Disease
WASHINGTON, DC - In light of recent findings that erythropoiesis-stimulating agents (ESAs) double the risk of stroke in patients with diabetes and chronic kidney disease (CKD) without substantially improving their quality of life, physicians should be cautious about prescribing these medications.
However, the agents may be warranted for certain patients with CKD who have severe anaemia and need frequent blood transfusions or who are candidates for a kidney transplant, according to an editorial appearing in an upcoming issue of the Journal of the American Society Nephrology.
To test darbepoeitin's effectiveness and safety in patients with CKD who have anaemia and were not on dialysis, investigators conducted the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).The study's results were recently published in the New England Journal of Medicine and presented at the annual meeting of the American Society of Nephrology (ASN) in San Diego, California.
During the study, a similar number of patients taking a placebo or darbepoetin died or experienced a myocardial infarction (MI) or other cardiovascular event. However, almost twice as many patients who were taking darbepoetin suffered a stroke. The ESA was also linked to a potential increased risk of developing cancer, while only modestly improving patients' quality of life.
Kidney expert Ajay Singh, MD, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, offers advice for nephrologists in this editorial to help manage anaemia in CKD patients.
In patients with mild to moderate anaemia, especially those who feel well or have only mild symptoms and low-level fatigue, Dr. Singh recommends iron therapy. "Avoiding use of ESAs in managing anaemia in non-dialysis patients with CKD is now the soundest approach given the remarkable observations from the TREAT study," wrote Dr. Singh.
He noted that a blood transfusion or treatment with a short course of an ESA may be necessary if anaemia worsens and the patient develops symptoms.
Dr. Singh stressed that most CKD patients who have cancer should be treated with blood transfusions, not ESAs. He indicated, however, that long-term treatment with ESAs should be considered for CKD patients who are candidates for a kidney transplant (who cannot receive blood transfusions) and for those who have more severe anaemia.
Dr. Singh added that more clinical trials are needed to answer a number of questions, such as whether there is a toxic dosage range of ESAs, if the frequency of administration of ESAs makes a difference, and whether the risks seen in TREAT also occur in dialysis patients with CKD.
"Dr. Singh's editorial appropriately pleads for cautious use of intravenous iron and ESAs in patients with CKD, commented Jeffrey S. Berns, MD, Nephrology Fellowship Training Program of the Renal-Electrolyte and Hypertension, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. "All of the major trials he discusses were conducted in patients with a high prevalence of diabetes and heavy burden of cardiovascular and other comorbid conditions. Determining the true generalisability of TREAT would depend on testing younger and healthier patients without comorbid conditions." Dr. Berns also points out that the risks and benefits of maintaining hemoglobin levels in CKD patients significantly below 10 g/dl is not known since TREAT and other trials maintained patient hemoglobin levels at or above this level.
SOURCE: American Society of Nephrology
However, the agents may be warranted for certain patients with CKD who have severe anaemia and need frequent blood transfusions or who are candidates for a kidney transplant, according to an editorial appearing in an upcoming issue of the Journal of the American Society Nephrology.
To test darbepoeitin's effectiveness and safety in patients with CKD who have anaemia and were not on dialysis, investigators conducted the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT).The study's results were recently published in the New England Journal of Medicine and presented at the annual meeting of the American Society of Nephrology (ASN) in San Diego, California.
During the study, a similar number of patients taking a placebo or darbepoetin died or experienced a myocardial infarction (MI) or other cardiovascular event. However, almost twice as many patients who were taking darbepoetin suffered a stroke. The ESA was also linked to a potential increased risk of developing cancer, while only modestly improving patients' quality of life.
Kidney expert Ajay Singh, MD, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, offers advice for nephrologists in this editorial to help manage anaemia in CKD patients.
In patients with mild to moderate anaemia, especially those who feel well or have only mild symptoms and low-level fatigue, Dr. Singh recommends iron therapy. "Avoiding use of ESAs in managing anaemia in non-dialysis patients with CKD is now the soundest approach given the remarkable observations from the TREAT study," wrote Dr. Singh.
He noted that a blood transfusion or treatment with a short course of an ESA may be necessary if anaemia worsens and the patient develops symptoms.
Dr. Singh stressed that most CKD patients who have cancer should be treated with blood transfusions, not ESAs. He indicated, however, that long-term treatment with ESAs should be considered for CKD patients who are candidates for a kidney transplant (who cannot receive blood transfusions) and for those who have more severe anaemia.
Dr. Singh added that more clinical trials are needed to answer a number of questions, such as whether there is a toxic dosage range of ESAs, if the frequency of administration of ESAs makes a difference, and whether the risks seen in TREAT also occur in dialysis patients with CKD.
"Dr. Singh's editorial appropriately pleads for cautious use of intravenous iron and ESAs in patients with CKD, commented Jeffrey S. Berns, MD, Nephrology Fellowship Training Program of the Renal-Electrolyte and Hypertension, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. "All of the major trials he discusses were conducted in patients with a high prevalence of diabetes and heavy burden of cardiovascular and other comorbid conditions. Determining the true generalisability of TREAT would depend on testing younger and healthier patients without comorbid conditions." Dr. Berns also points out that the risks and benefits of maintaining hemoglobin levels in CKD patients significantly below 10 g/dl is not known since TREAT and other trials maintained patient hemoglobin levels at or above this level.
SOURCE: American Society of Nephrology
Avoiding Anemia and Nutritional Deficiencies Following Bariatric Surgery
Bariatric surgery, also known as weight loss surgery, has become increasingly popular in recent years to help the morbidly obese permanently reduce their weight. In the past decade the number of surgeries has increased more than 10-fold with about 220,000 surgeries taking place in the United States in 2008 alone.
Despite its increasing popularity and considerable success, bariatric surgery does not come without important nutritional considerations. Many bariatric patients develop new or worsen preexisting iron and vitamin deficiencies, with some patients becoming anemic in the months and years following the procedure. This article discusses how nutritional deficiencies can develop and provides tips on how to avoid deficiencies and anemia following the procedure.
What if I have anemia or a nutritional deficiency before surgery?
It is not uncommon for morbidly obese patients to have anemia or nutritional deficiencies prior to surgery. In fact, some studies have indicated that up to 22% of bariatric surgery recipients had anemia prior to surgery.1 If you have anemia, it is important that your doctor or surgeon determine the cause of your anemia and to take steps to treat it before surgery. Detecting anemia and treating it are essential steps that can help reduce your need for a blood transfusion during or after surgery.2 Visit the Information Handout Anemia & Surgery for more information about anemia as it relates to general surgical procedures (not specific to bariatric surgery).
Nutritional deficiencies can also be common for morbidly obese patients considering bariatric surgery. According to Dr. John W. Baker, President of the American Society for Metabolic & Bariatric Surgery (ASMBS), about 60% of his patients have low levels of vitamin B12 prior to surgery and about 20% have iron deficiency. If your doctor or your surgeon detects that you have a nutritional deficiency, he or she will take appropriate steps to determine why this is occurring and recommend steps to return levels back to their normal range.
If you already decided to have the surgery, your surgeon should recommend that you take a multivitamin every day as part of preparing your body for the procedure. If you have a vitamin B12 deficiency or folate deficiency, taking this multivitamin may be all that your doctor recommends. If your doctor or surgeon detects that you have an iron deficiency, they may recommend that you take an oral iron supplement in addition to the daily multivitamin. You can read more about treatments for iron deficiency in our articles A Patient’s Guide to Oral Iron Supplements and Are Iron Injections Right for You? Be sure to tell your doctor or surgeon if you were not able to take all of the recommended oral iron doses and report any side effects you may be experiencing. All oral iron supplements will cause your stool to become dark in color.
How does the surgery alter my body?
There are many types of surgeries, known collectively as bariatric surgery, which can help morbidly obese patients lose weight when combined with healthy lifestyle behaviors and a nutritious diet. These surgical procedures help patients lose weight by altering the shape of the digestive tract and by effecting how the stomach and intestines process and absorb food.
How the surgical procedures alter the body can vary
Some procedures are “restrictive,” which means they reduce the capacity of the digestive tract and lower the number of calories a person can consume. Some procedures are “malabsorptive,” which means they alter the way the stomach and intestines absorb nutrients from food. Several bariatric procedures use a combination of the restrictive and malabsorptive approaches together.
The two types of surgeries that use restrictive methods only include vertical banded gastroplasty (VBG) and laparoscopic adjustable gastric banding (LAGB). Malabsorptive procedures with some restriction include biliopancreatic diversion (BPD) and biliopancreatic diversion with duodenal switch (BPD-DS). Restrictive procedures with some malabsorption include roux-en-Y gastric bypass (RYGB) and vertical banded gastric bypass. Discuss the different types of procedures with your surgeon to find out which one you have received or will receive.
Although the restrictive and malabsorptive approaches can help morbidly obese patients lose weight, altering the way you absorb nutrients can lead to iron deficiency, vitamin B12 deficiency or folate deficiency.1,3 Continued deficiencies of even one of these three nutrients can lead to a person becoming anemic over time. For the rest of their lives, patients who received bariatric surgery will need to take additional steps to prevent and possibly treat nutritional deficiencies and anemia.3
What can I do to prevent nutritional deficiencies?
There are several steps that you can take – both before and after surgery – to prevent nutritional deficiencies and reduce your risk for anemia. Some of these actions include:
Follow-up Programs – Once you have committed to receive the surgery, learning about the procedure and eating a healthy diet will begin when your surgeon enrolls you in a bariatric surgery program. Bariatric surgery programs start before surgery and continue well after surgery to help monitor your health and behavior. These programs can help you adjust to your new lifestyle and reinforce the importance of following dietary restrictions and taking the iron and vitamin supplements recommended by your surgeon. Participating in the follow-up portion of the programs is an essential part of staying healthy after bariatric surgery.
Eating Healthy – A healthy and balanced diet is important to reduce your chances of acquiring a nutritional deficiency. To avoid anemia, this includes eating foods that are rich in iron, vitamin B12 and folic acid. You can read about how your body uses these nutrients and why they are important for preventing anemia in our articles about Anemia and Nutrition: The Importance of Iron and The Importance of Essential Vitamins. Each of the articles list foods that contain these nutrients.
Nutritional Supplementation – Taking nutritional supplements like multivitamins and oral iron can help ensure you receive enough nutrients through your diet. Because your stomach will be smaller, you may not be able to receive enough of the nutrients you need just from food. Concerning anemia-related nutrients, the multivitamin should include at least 100% of daily value for vitamin B12, 400 μg of folic acid, and 18 mg of iron.4 Even though the multivitamin contains iron, patients with a known iron deficiency may also need to take oral iron. You can read more about treating iron deficiency in our articles A Patient’s Guide to Oral Iron Supplements and Are Iron Injections Right for You?
Nutrient Absorption – In addition to getting enough nutrients in your diet, it can be important to increase your body’s ability to absorb the nutrients when they are in your digestive system. You can maximize iron absorption by eating foods that contain vitamin C, like citrus fruits, with your iron-rich foods and oral iron. Other items, like tea, cola, milk, coffee, calcium supplements and the hormone levothyroxine can decrease the amount of iron that is absorbed from food and supplements. Generally it is best to wait two hours before consuming these liquids or medications. For more tips on increasing iron absorption, read the article Anemia and Nutrition: The Importance of Iron.
What can my doctor do to monitor for deficiencies?
Regular check-ups with your surgeon and/or your primary doctor can help ensure that you are not developing nutritional deficiencies or anemia. These check-ups can either occur with your surgeon or with your primary care doctor, but it is important to discuss a follow-up schedule with both parties before surgery. Surgeons may enroll their patients in a bariatric surgery program that requires follow-up visits at the first, third, sixth and 12th months after the procedure. These scheduled visits help surgeons monitor your overall health and address any complications or symptoms you may be experiencing. Annual check-ups are recommended thereafter.
The visits at six and twelve months are especially important so that surgeons can perform simple blood tests to make sure patients are not acquiring nutritional deficiencies. Tests often measure the amount of vitamin B12, folate or iron that is stored in your body. If a nutritional deficiency is detected, your doctor will take appropriate steps to determine why this is occurring. It is possible that you may not have enough stored nutrients because your digestive tract is still not absorbing them properly from the food you eat and the supplements you’ve been taking. If this is the case, there are intravenous methods (through an IV) that directly inject nutrients into your bloodstream. Read more about other causes for Vitamin Deficiency Anemia, Iron Deficiency Anemia and other causes of anemia in NAAC’s Information Handouts.
In addition to testing, it is important to tell your doctor and surgeon about any unusual symptoms you may be experiencing. Symptoms which may be caused by anemia include feeling tired, fatigued, weak, dizzy, irritable or short of breath. You may also have pale skin, brittle nails, chest pain, an irregular heartbeat, or coldness in your hands or feet. Anemia caused by a vitamin B12 deficiency can also cause your tongue to be smooth and bright red, and may lead to a tingling or numbness in your hands and feet. Without treatment, these symptoms may develop slowly and become more severe over time.
Your Health After Surgery
When combined with a healthy diet and lifestyle behaviors, bariatric surgery is an extremely helpful procedure that can assist morbidly obese patients shed excess weight and reduce the occurrence of obesity-related health conditions like hypertension, heart disease, diabetes, sleep apnea and high cholesterol.5
However, due to the considerable changes to the digestive tract, patients who receive bariatric surgery can develop new or worsen preexisting nutritional deficiencies, with some patients becoming anemic in the months and years following the procedure. To avoid these complications it is essential to eat a healthy diet, take your prescribed supplements and regularly visit your doctor to monitor your overall health and nutrient levels. Close communication with your doctor and surgeon will help them provide any necessary treatment for anemia or nutritional deficiencies.
Common Types of Bariatric Surgeries
Restrictive Only
Vertical banded gastroplasty (VBG)
Laparoscopic adjustable gastric band (LAGB)
Malabsorptive with Some Restriction
Biliopancreatic diversion (BPD)
Biliopancreatic diversion w/ duodenal switch (BPD-DS)
Restrictive with Some Malabsorption
Roux-en-Y gastric bypass (RYGB)
Vertical banded gastric bypass
References
Von Drygalski A, Andris DA. Anemia after bariatric surgery: more than just iron deficiency. Nutr Clin Pract. 2009 Apr-May;24(2):217-26. Link.
Faris PM, Spence RK, Larholt KM, Sampson AR, Frei D. The predictive power of baseline hemoglobin for transfusion risk in surgery patients. Orthopedics. 1999 Jan;22(1 Suppl):s135-40. Link.
American Society for Metabolic & Bariatric Surgery. Guidelines. Bariatric Surgery: Postoperative Concerns. Link. Revised: February 7, 2008.
Allied Health Sciences Section Ad Hoc Nutrition Committee, Aills L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. Surg Obes Relat Dis. 2008 Sep-Oct;4(5 Suppl):S73-108. Link. (PDF)
American Society for Metabolic & Bariatric Surgery. Metabolic & Bariatric Surgery Fact Sheet. Link. Revised: July 2009. (PDF)
SOURCE: anemia.org
Credit: Anemia.org
A NAAC Article (NATIONAL ANEMIA ACTION COUNCIL)
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